Federal health officials warn of W.Va. diabetes epidemic

CHARLESTON, W.Va. -- Top officials of the Appalachian Regional Commission and the Centers for Disease Control said Thursday that West Virginia's Type 2 diabetes problem is so serious, the state must create a statewide network of prevention programs soon to help residents avoid the disease.

"We can't afford not to do this," said Ann Allbright, CDC's top diabetes official, speaking to a roundtable of about 40 key state health, insurance and advocacy group officials in Charleston.

Diabetes already costs West Virginia more than $1 billion per year, according to the American Diabetes Association. "It will cost $3 billion by 2025, if we don't take steps to stop it," said Gina Wood, director of the West Virginia Diabetes Prevention and Control Program.

CDC is trying to spread prevention efforts nationwide. "We cannot fail or we will continue to pay incredible amounts of money to treat diabetes," Allbright said. "We have an opportunity to make a huge difference."

At least 174,000 West Virginians already have Type 2 diabetes, by CDC estimates. The Gallup Healthways poll estimates about 250,000.

Another 466,000 West Virginians have pre-diabetes, meaning their blood sugar is at near-diabetes levels, Wood said. Only about 80,000 are aware that they are in danger of diabetes, she said.

"We've got a whole bunch of people who are very close to stepping into the expensive world of diabetes," Allbright said. To prevent that, she urged the health leaders to find a way to offer the National Diabetes Prevention Program statewide, in locations such as senior centers, churches and businesses.

"Research has proven that, if people follow that program, they can reduce their diabetes risk by as much as 70 percent," she said. The program is based on studies that show that modest weight loss and increased physical activity prevents or delays diabetes in 58 percent of pre-diabetics.

"The savings are obvious," Allbright said. A diabetic person costs the health system about $10,000 more yearly than a non-diabetic does, the American Diabetic Association has estimated, and the NDPP program costs about $400 per person to deliver.

Dick Whitberg, director of the Mid-Ohio Valley Health Department, said his agency already offers the NDPP program in five locations. "People are loving it," he said. "We have a waiting list." The key is to take it to people, not to expect them to come to an office, he said.

"We're offering it in churches, two businesses, and senior centers," he said. The waiting list includes businesses, senior centers and individuals referred by doctors, he said.

His staff, already trained in NDPP, has been visiting local physicians to tell them about the program. "It works," he said.

At this point, no insurance companies have agreed to reimburse agencies for the program. "That's the problem," Whitberg said, "and it has to be solved. Right now, we're doing it as part of what we do, because it's important to get this going. We're training 10 more people soon to deliver it."

No other agency is yet offering the program. "We would like to offer it, but we can't use medical claims for a program delivered by lay people," said Nidia Henderson, Public Employees Insurance Agency wellness coordinator. The 16-session NDPP program is delivered by trained coaches who are certified by CDC-approved programs.

"We're working very hard to solve the reimbursement problem nationwide," Allbright said. "We aim to have all insurance paying for it."

There is solid research that shows the program gets the same positive results with certified trainers, whether or not they are health professionals, she said.

Cindy Fitch, WVU Extension director of Families and Health programs, said several of her staff members are certified and ready to start the program in seven counties. "We may have to start without insurance reimbursement. We think it's important to begin."

WVU's Extension Service hopes to eventually offer the program statewide. Marshall University will also soon offer the program.

Sen. Jay Rockefeller, D-W.Va., has submitted a bill to allow Medicare to reimburse agencies for providing the NDPP program. Medicaid and Medicare insure approximately 40 percent of West Virginians.

It will take similar federal action for Medicaid, said Nancy Atkins, state Medicaid commissioner. "Medicaid is not known for paying for prevention, but we've got to do things differently. We can't keep paying for more and more diabetes."

Wood, with the diabetes prevention and control program, said her office would soon offer an informational webinar for interested groups. "We're moving forward," she said.

Her staff is helping health agencies use the state's diabetes registry to identify their pre-diabetic patients "so they can be ready to help them take preventative steps."

The NDPP focuses on pre-diabetic adults, Allbright said, but similar programs need to be created for children.

In a videotaped message, Rockefeller called Type 2 diabetes "a statewide epidemic" and urged the group to take serious action.

"The Shape We're In" has been partially funded by a Dennis A. Hunt Fund for Health Journalism fellowship, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.